Knowledge Networks for Treating Complex Diseases in Remote, Rural, and Underserved Communities

Abstract

Project ECHO (Extension for Community Healthcare Outcomes) is an innovative healthcare program developed to address the treatment of patients with chronic and complex diseases in rural and underserved areas of New Mexico. Through the use of technology and iterative, case-based discussion with ongoing support, the model used in Project ECHO bridges the gap between academic healthcare specialists and providers in rural and underserved settings. Its prime foci are the provision of workplace learning, evidence-based practices, and the delivery of best quality care to patients with chronic diseases. Collaboration between academic specialists and community-based providers enables patients to receive state-of-the-art healthcare from the professionals they know and trust in their own communities. For local providers, co-management of the often lengthy and involved treatments gives them additional expertise in competencies associated with chronic disease and involves them in continuing communication and patient management. As they learn more about specific chronic diseases, the community-based providers become engaged with expanded networks of providers and organizations, become more satisfied in their work, and experience less professional isolation. With continued involvement, community-based providers become highly skilled in the treatment of these chronic and complex diseases, thus creating centers of excellence in their own communities. This chapter describes the activities and outcomes associated with the collaborative, iterative, and workplace-focused care of patients with Hepatitis C, the first chronic disease to be addressed, and how new modes of collaboration were forged between specialists in academic settings and community-based primary care providers in rural and underserved communities. Work on other chronic diseases is now being organized using a similar approach to developing expanded expertise in rural and underserved areas of the state.